Cardiovascular fitness, insulin resistance and metabolic syndrome in severely obese prepubertal Italian children.
OBJECTIVE
To evaluate if insulin resistance (IR) and metabolic syndrome (MS) were associated with poor cardiovascular fitness in very obese prepubertal Italian subjects.


METHODS
Children referred to the Endocrinology and Diabetes Unit of Bambino Gesù Children's Hospital underwent an OGTT with glucose and insulin assays. QUICKI, ISI and HOMA-IR were calculated. Total and HDL cholesterol, triglycerides and percentage of body fat (DEXA) were determined. Cardiovascular fitness (maximal treadmill time) was evaluated using a treadmill protocol. The MS was defined as having 3 or more of following risk factors: obesity, impaired glucose tolerance, high blood pressure, low HDL-cholesterol, high triglycerides.


RESULTS
Fifty-five very obese prepubertal Italian children were enrolled in the study. Unadjusted correlation revealed maximal treadmill time negatively related to fasting insulin (r = -0.53, p < 0.0001) and HOMA-IR (r = -0.57, p < 0.0001) and positively to QUICKI (r = 0.51, p < 0.0001) and ISI (r = 0.46, p = 0.0035). These relationships remained significant when in multivariate analysis age, gender, BMI SD and body composition were accounted for (all p < 0.01). The presence of the MS was independently associated with maximal treadmill time.


CONCLUSIONS
Poorcardiovascular fitness, IR and MS were independently related, suggesting that the relationship between fitness and insulin action develops early in life.
Brufani
Claudia
C
Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy. cbrufani@libero.it
Grossi
Armando
A
Fintini
Danilo
D
Fiori
Rossana
R
Ubertini
Graziamaria
G
Colabianchi
Diego
D
Ciampalini
Paolo
P
Tozzi
Alberto
A
Barbetti
Fabrizio
F
Cappa
Marco
M
D000367:Age Factors; D001823:Body Composition; D002319:Cardiovascular System / Q000503:physiopathology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005080:Exercise Test; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000503:physiopathology; D010809:Physical Fitness; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D014280:Triglycerides